Objective

To assess the attendance, outcome, compliance with treatment, and response to interferon alfa in patients with chronic hepatitis C who attended during 1995 and were treated according to a biopsy based algorithm.

Design

Retrospective audit of all patients with chronic hepatitis C attending outpatient clinics over one year.

Setting

The liver unit at a London teaching hospital.

Subjects

Response to interferon alfa treatment, based on loss of viraemia three months after cessation of treatment Results : A large proportion of patients (39%) with newly diagnosed chronic hepatitis C infection do not want to undergo further investigation.

Of those patients who do attend for further treatment, a large proportion with severe hepatic fibrosis (42%) do not want to undergo currently available treatment The response rate to interferon (21%) in treated patients was similar to that previously reported in a trial setting.

There was no significant difference in response rates in patients with or without severe fibrosis not amounting to cirrhosis.

In patients with cirrhosis there was a high incidence of hepatocellular carcinoma (18%) over a follow up period of 20 months.

Conclusion

Current strategies aimed at investigating and treating patients with chronic hepatitis C are not acceptable to a large proportion of patients. (...)